Monitoring food and health news -- with particular attention to fads, fallacies and the "obesity" war

Summary of findings to date: Everything you can possibly eat or drink is both bad and good for you

"Let me have men about me that are fat... Yond Cassius has a lean and hungry look ... such men are dangerous." -- Shakespeare

Monday, May 21, 2012

Another glass of doublethink?

As you may have noticed, we've been pretty preoccupied with the nanny state this week. With Monday's minimum alcohol pricing announcement in Scotland, Tuesday's release of "The Wages of Sin Taxes", Chris Snowdon's excellent debunking of the arguments for sin taxes, and yesterday's call by British Medical Association writers to bring in a "fat tax" on fatty foods (not that anyone can agree on what those are), it seems that there's hardly a single bit of fun someone in power doesn't want to discourage with a tax or price floor.

It's all very dispiriting, but what's striking is how economically sound it all is. These paternalists might have no regard for individual liberty; they might have a puritan's appreciation of the power of a bottle of wine to lubricate human relationships; they might even long for two extra years in a care home in Kent. And you have to admire their pragmatism in stamping out the things they disapprove of — generally speaking, poor people living unhealthy lifestyles. They grasp the fundamental law of economics that incentives matter.

But in in proposing things like taxes on Coca-Cola are price floors for alcohol, the puritans have given the game away. They've accepted free market logic that contravenes all the other things they tend to support. If taxing Coca-Cola makes people drink Coca-Cola less, then taxing work via the income tax must make people work less. If a price floor for alcohol makes people drink less booze (binge drinkers' low price elasticities of demand notwithstanding), then the price floor for labour we call the National Minimum Wage must make firms hire fewer people.

Even the infamous "pasty tax", which I oppose – there's no such thing as a good tax rise, in my book – is criticised by many on the left as a tax on "working class food". What is a minimum price floor on alcohol, if not an attack on "working class booze"?

The elite that wants to impose its lifestyle on the rest of us may be using this sort of thinking for evil, but more people accepting the logic of economic thinking is generally a good thing. Not many people actively want more unemployment or less productivity. With any luck, it will turn out that not many people actively want to be told by their betters how to eat and socialize either.

In 2008, Emma Murphy phoned her partner Joe at work. ‘I know what’s wrong with the children,’ she said.

For four years the couple had been perplexed by the health problems that affected their daughters Chloe and Lauren and their son Luke – and their GP had consistently dismissed their concerns.

It was only after watching a television programme about Fetal Anticonvulsant Syndrome (FACS) that Emma realised the children, who all had special needs, had been irreversibly damaged in the womb by the anti-epileptic drugs she had taken since she was 12.

After the scandal of the devastating birth defects caused by the morning-sickness drug Thalidomide in the Fifties, it seems inconceivable that the same situation could occur again. But for thousands of families in the UK, the word Epilim has the same sinister connotations.

It has been prescribed since 1978 and reports of the ingredient sodium valproate causing birth defects such as spina bifida go back almost as far. FACS is believed to have affected up to 20,000 babies – ten times more than Thalidomide.

FACS is thought to be caused in the first three months of pregnancy when an anti-epileptic drug crosses the placenta into the foetus. Effects depend on the dosage and the drug.

There are three FACS syndromes, each involving different anti-epileptic drugs and each with their own set of symptoms. In 2010, Epilim was taken by more than 21,500 women aged between 20 and 39 for epilepsy and other conditions. It is indicated in 80 per cent of cases of FACS.

Dr Peter Turnpenny, clinical geneticist at the Royal Devon and Exeter Hospital, says: ‘Epilim may affect about 560 babies every year, and 10,000 to 20,000 since being introduced to the UK.’

FACS is, Dr Turnpenny points out, less dramatic than the missing and distorted limbs caused by Thalidomide, but the neurological effects are far worse. ‘About ten per cent of foetuses exposed to sodium valproate will have a major congenital malformation such as cleft palate. Twelve per cent are likely to be diagnosed with a neuro-developmental disorder.’

Emma, 31, was prescribed Epilim after developing epilepsy as a girl. She and Joe, 39, a taxi driver, were oblivious to the concerns about the drug.

Their first three children were born prematurely. Within 24 hours they became limp and unresponsive. All had delayed speech and Lauren and Luke were late walkers. Lauren was diagnosed with cerebral palsy aged two.

Emma saw the TV programme on FACS when she was four months pregnant with their youngest daughter Erin, now four. She heard one mother, Janet Williams, describing the symptoms experienced by her two sons who have FACS. ‘I knew straight away,’ Emma says. She contacted the Organisation for Anticonvulsant Syndrome, a support group founded in 1999 by Janet.

Emma’s GP finally referred her to a geneticist who recognised immediately the characteristic facial features in the children – a thin upper lip, small, crowded teeth and wide nasal bridge.

A year later, Emma’s youngest son Kian was conceived – an unplanned pregnancy when Emma took a course of antibiotics that may have reduced the effectiveness of her contraceptive pill. Although Emma immediately changed her Epilim for Keppra, a newer drug with no known links to FACS, it was too late.

All five children have hypermobile joints, which means they are excessively bendy and painful at night. Lauren needs a walking frame and she and Luke have support workers at school. Joe has been forced to give up work because of Emma’s epilepsy and the children’s needs.

Janet Williams, whose sons are now in their 20s, says: ‘I saw my GP and my gynaecologist when I was pregnant and was told to keep taking the Epilim. There wasn’t an information leaflet in the box at that time. I trusted the medical profession.’

Emma agrees. ‘As soon as I found out I was pregnant, I asked my GP whether my medication was safe. Because of the severity of my epilepsy, I was under a team of medics throughout all my pregnancies. I was never warned.’

Both women are calling for anyone prescribing anti-epileptic drugs to warn of the risks during pregnancy.

‘The problem is that Epilim is a very good drug,’ says consultant neurologist Suzanne O’Sullivan at BMI The London Independent Hospital. ‘These days we avoid putting women of childbearing age on it as a first-choice drug. Not all doctors are aware of the risk.’

No one is suggesting that women stop taking their anti-epileptic drugs. ‘Major convulsive seizures could cause injury to the baby or a miscarriage, but there are other effective drugs available that are known to be safe during pregnancy,’ says consultant neurologist Dr Jim Morrow at the Royal Victoria Hospital, Belfast.

‘If you have epilepsy and are considering having children, see your specialist and plan two years in advance as it may take this long to change your drug regime,’ adds Dr O’Sullivan.

A spokesman for Sanofi, which makes Epilim, says: ‘We have always provided appropriate information and warnings in relation to the potential side effects and risks associated with use of this medicine, including risks to the unborn child, in line with developing scientific knowledge.

‘Sodium valproate remains the most effective treatment of generalised epilepsy. Sanofi has been proactive in supporting ongoing research to evaluate the risk-benefit profile in all patient groups and continues to work closely with the scientific and medical communities.’

But David Irwin, solicitor at medical specialists Irwin Mitchell, claims the manufacturer did not give adequate warnings in its product leaflets before 1997. In 2006, about 140 affected families launched a case against the manufacturer. It collapsed last year and legal aid was withdrawn as it was thought there was insufficient evidence to win.

Emma doesn’t care about compensation, just that other families are not torn apart. ‘Our lives revolve around caring for the children’s complicated health needs and we don’t know what the future holds,’ she says. ‘I want the medical profession to be educated about it and for women to be in a position to make an informed choice.’

1 comment:

How my daughter was saved from grand mal seizure.I am not really a fan of sharing my personal private story on the internet but i decided to do this because this joy is too voluminous for me to hide. My daughter which i took over 8 years after marriage to conceive had her first seizure at age 8 and ever since then it has been from one seizure to another in school, in church, at picnics. This got me worried because she has a bright future that i do not want epilepsy to become a hindrance, i tried several doctors in Texas and none could help with an effective cure. I went on the internet and saw testimonies about a treatment for epilepsy which a doctor offered and i was interested, i got in contact with him and i was able to get the medicine for my daughter which she used for 3 months as he instructed and it has been over 6 months now she is doing just fine without any allergies or aftermath effects. If you are suffering problem try to reach him too on (josephalberteo@gmail.com) i can count on him for a cure for you too.

Where it is not bunk is when it shows that some treatment or influence has no effect on lifespan or disease incidence. It is as convincing as disproof as it is unconvincing as proof. Think about it. As Einstein said: No amount of experimentation can ever prove me right; a single experiment can prove me wrong.

Epidemiological studies are useful for hypothesis-generating or for hypothesis-testing of theories already examined in experimental work but they do not enable causative inferences by themselves

The standard of reasoning that one commonly finds in epidemiological journal articles is akin to the following false syllogism:
Chairs have legs
You have legs
So therefore you are a chair

I am rather in despair that important medical research is plagued by arrant nonsense. The simple truth that correlation is not causation seems unknown to most medical writers. As a last ditch attempt to get that truth into a few more skulls let me be "offensive". Offensiveness may serve to get the matter noticed. So here is the story: There is about a -.5 correlation between lip size and IQ. Big lips predict low IQ. Your run-of-the mill medical researcher will pounce on that as a huge breakthrough in finding the causes of IQ -- and propound new theories about things such as blood circulation to explain how lips affect IQ. But that is nonsense. Big lips are mostly found on people of African ancestry and, as all the studies attest, Africans are a very low IQ group. The correlation arises because of heredity, not lip size. There is a third factor behind the correlation -- and the possibility of such third factors seems to be a jaw-dropping surprise to most medical researchers

SALT -- SALT -- SALT

1). A good example of an epidemiological disproof concerns the dreaded salt (NaCl). We are constantly told that we eat too much salt for good health and must cut back our consumption of it. Yet there is one nation that consumes huge amounts of salt. So do they all die young there? Quite the reverse: Japan has the world's highest concentration of centenarians. Taste Japan's favourite sauce -- soy sauce -- if you want to understand Japanese salt consumption. It's almost solid salt.

2). We need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. So the conventional wisdom is not only wrong. It is positively harmful

3). Table salt is a major source of iodine, which is why salt is normally "iodized" by official decree. Cutting back salt consumption runs the risk of iodine deficiency, with its huge adverse health impacts -- goiter, mental retardation etc. GIVE YOUR BABY PLENTY OF SALTY FOODS -- unless you want to turn it into a cretin

4). Our blood has roughly the same concentration of salt as sea-water so claims that the body cannot handle high levels of salt were always absurd

5). The latest academic study shows that LOW salt in your blood is most likely to lead to heart attacks. See JAMA. 2011;305(17):1777-1785. More here and here and here for similar findings. Salt is harmless but a deficiency of it is not. We need it. See also here

PEANUTS: There is a vaccination against peanut allergy -- peanuts themselves. Give peanut products (e.g. peanut butter -- or the original "Bamba" if you have Israeli contacts) to your baby as soon as it begins to take solid foods and that should immunize it for life. See here and here (scroll down). It's also likely that a mother who eats peanuts while she is lactating may confer some protection on her baby. See here

THE SIDE-EFFECT MANIA. If a drug is shown to have troublesome side-effects, there are always calls for it to be banned or not authorized for use in the first place. But that is insane. ALL drugs have side effects. Even aspirin causes stomach bleeding, for instance -- and paracetamol (acetaminophen) can wreck your liver. If a drug has no side effects, it will have no main effects either. If you want a side-effect-free drug, take a homeopathic remedy. They're just water.

Although I am an atheist, I have never wavered from my view that the New Testament is the best guide to living and I still enjoy reading it. Here is what the apostle Paul says about vegetarians: "For one believeth that he may eat all things: another, who is weak, eateth herbs. Let not him that eateth despise him that eateth not; and let not him which eateth not judge him that eateth." (Romans 14: 2.3). What perfect advice! That is real tolerance: Very different from the dogmatism of the food freaks. Interesting that vegetarianism is such an old compulsion, though.

Even if we concede that getting fat shortens your life, what right has anybody got to question someone's decision to accept that tradeoff for themselves? Such a decision could be just one version of the old idea that it is best to have a short life but a merry one. Even the Bible is supportive of that thinking. See Ecclesiastes 8:15 and Isaiah 22: 13. To deny the right to make such a personal decision is plainly Fascistic.

Obesity does NOT causes diabetes. But insatiable eating is a prominent symptom of diabetes. So diabetes DOES cause obesity, which accounts for the correlation between the two things. The streets are full of fatties who don't have diabetes. How come? If conventional medical theory were correct we should be in the midst of an epidemic of diabetes. A recent high quality study has also found that fatties are LESS likely to die of diabetes

Elite people frequently express disapproval of red meat eating as a way of expressing their felt superiority to the ordinary people who eat it

IQ: Political correctness makes IQ generally unmentionable so it is rarely controlled for in epidemiological studies. This is extremely regrettable as it tends to vitiate findings that do not control for it. When it is examined, it is routinely found to have pervasive effects. We read, for instance, that "The mother's IQ was more highly predictive of breastfeeding status than were her race, education, age, poverty status, smoking, the home environment, or the child's birth weight or birth order". So political correctness can render otherwise interesting findings moot

"To kill an error is as good a service as, and sometimes better than, the establishing of a new truth or fact" -- Charles Darwin

"Most men die of their remedies, not of their diseases", said Moliere. That may no longer be true in general but there is still a lot of false medical "wisdom" around that does harm to various degrees -- the statin and antioxidant fads, for instance. And showing its falsity is rarely the problem. The problem is getting people -- medical researchers in particular -- to abandon their preconceptions

Bertrand Russell could have been talking about today's conventional dietary "wisdom" when he said: "The fact that an opinion has been widely held is no evidence whatever that it is not utterly absurd; indeed in view of the silliness of the majority of mankind, a widespread belief is more likely to be foolish than sensible.”

The challenge, as John Maynard Keynes knew, "lies not so much in developing new ideas as in escaping from old ones".

"Obesity" is 77% genetic. So trying to make fatties slim is punishing them for the way they were born. That sort of thing is furiously condemned in relation to homosexuals so why is it OK for fatties?

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Some more problems with the "Obesity" war:

1). It tries to impose behavior change on everybody -- when most of those targeted are not obese and hence have no reason to change their behaviour. It is a form of punishing the innocent and the guilty alike. (It is also typical of Leftist thinking: Scorning the individual and capable of dealing with large groups only).

2). The longevity research all leads to the conclusion that it is people of MIDDLING weight who live longest -- not slim people. So the "epidemic" of obesity is in fact largely an "epidemic" of living longer.

3). It is total calorie intake that makes you fat -- not where you get your calories. Policies that attack only the source of the calories (e.g. "junk food") without addressing total calorie intake are hence pissing into the wind. People involuntarily deprived of their preferred calorie intake from one source are highly likely to seek and find their calories elsewhere.

4). So-called junk food is perfectly nutritious. A big Mac meal comprises meat, bread, salad and potatoes -- which is a mainstream Western diet. If that is bad then we are all in big trouble.

5). Food warriors demonize dietary fat. But Eskimos living on their traditional diet eat huge amounts of fat with no apparent ill-effects. At any given age they in fact have an exceptionally LOW incidence of cardiovascular disease. And the average home-cooked roast dinner has LOTS of fat. Will we ban roast dinners?

6). The foods restricted are often no more calorific than those permitted -- such as milk and fruit-juice drinks.

7). Tendency to weight is mostly genetic and is therefore not readily susceptible to voluntary behaviour change.

8). And when are we going to ban cheese? Cheese is a concentrated calorie bomb and has lots of that wicked animal fat in it too. Wouldn't we all be better off without it? And what about butter and margarine? They are just about pure fat. Surely they should be treated as contraband in kids' lunchboxes! [/sarcasm].

9). And how odd it is that we never hear of the huge American study which showed that women who eat lots of veggies have an INCREASED risk of stomach cancer? So the official recommendation to eat five lots of veggies every day might just be creating lots of cancer for the future! It's as plausible (i.e. not very) as all the other dietary "wisdom" we read about fat etc.

10). And will "this generation of Western children be the first in history to lead shorter lives than their parents did"? This is another anti-fat scare that emanates from a much-cited editorial in a prominent medical journal that said so. Yet this editorial offered no statistical basis for its opinion -- an opinion that flies directly in the face of the available evidence.

11). A major cause of increasing obesity is certainly the campaign against it -- as dieting usually makes people FATTER. If there were any sincerity to the obesity warriors, they would ban all diet advertising and otherwise shut up about it. Re-authorizing now-banned school playground activities and school outings would help too. But it is so much easier to blame obesity on the evil "multinationals" than it is to blame it on your own restrictions on the natural activities of kids

12. Fascism: "What we should be doing is monitoring children from birth so we can detect any deviations from the norm at an early stage and action can be taken". Who said that? Joe Stalin? Adolf Hitler? Orwell's "Big Brother"? The Spanish Inquisition? Generalissimo Francisco Franco Bahamonde? None of those. It was Dr Colin Waine, chairman of Britain's National Obesity Forum. What a fine fellow!

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Trans fats: For one summary of the weak science behind the "trans-fat" hysteria, see here. Trans fats have only a temporary effect on blood chemistry and the evidence of lasting harm from them is dubious. By taking extreme groups in trans fats intake, some weak association with coronary heart disease has at times been shown in some sub-populations but extreme group studies are inherently at risk of confounding with other factors and are intrinsically of little interest to the average person.

The "antioxidant" religion: The experimental evidence is that antioxidants SHORTEN your life, if anything. Studies here and here and here and here and here and here and here and here, for instance. That they are of benefit is a great theory but it is one that has been coshed by reality plenty of times.

The medical consensus is often wrong. The best known wrongheaded medical orthodoxy is that stomach ulcers could not be caused by bacteria because the stomach is so acidic. Disproof of that view first appeared in 1875 (Yes. 1875) but the falsity of the view was not widely recognized until 1990. Only heroic efforts finally overturned the consensus and led to a cure for stomach ulcers. See
here and here and here.

Dieticians are just modern-day witch-doctors. There is no undergirding in double-blind studies for their usual recommendations

The fragility of current medical wisdom: Would you believe that even Old Testament wisdom can sometimes trump medical wisdom? Note this quote: "Spiess discussed Swedish research on cardiac patients that compared Jehovah's Witnesses who refused blood transfusions to patients with similar disease progression during open-heart surgery. The research found those who refused transfusions had noticeably better survival rates.

Medical wisdom can in fact fly in the face of the known facts. How often do we hear reverent praise for the Mediterranean diet? Yet both Australians and Japanese live longer than Greeks and Italians, despite having very different diets. The traditional Australian diet is in fact about as opposite to the Mediterranean diet as you can get. The reverence for the Mediterranean diet can only be understood therefore as some sort of Anglo-Saxon cultural cringe. It is quite brainless. Why are not the Australian and Japanese diets extolled if health is the matter at issue?

Since many of my posts here make severe criticisms of medical research, I should perhaps point out that I am also a severe critic of much research in my own field of psychology. See here and here

This is NOT an "alternative medicine" site. Perhaps the only (weak) excuse for the poorly substantiated claims that often appear in the medical literature is the even poorer level of substantiation offered in the "alternative" literature.

I used to teach social statistics in a major Australian university and I find medical statistics pretty obfuscatory. They seem uniformly designed to make mountains out of molehills. Many times in the academic literature I have excoriated my colleagues in psychology and sociology for going ga-ga over very weak correlations but what I find in the medical literature makes the findings in the social sciences look positively muscular. In fact, medical findings are almost never reported as correlations -- because to do so would exhibit how laughably trivial they generally are. If (say) 3 individuals in a thousand in a control group had some sort of an adverse outcome versus 4 out of a thousand in a group undergoing some treatment, the difference will be published in the medical literature with great excitement and intimations of its importance. In fact, of course, such small differences are almost certainly random noise and are in any rational calculus unimportant. And statistical significance is little help in determining the importance of a finding. Statistical significance simply tells you that the result was unlikely to be an effect of small sample size. But a statistically significant difference could have been due to any number of other randomly-present factors.

"The modern literature on hate crimes began with a remarkable 1933 book by Arthur Raper titled The Tragedy of Lynching. Raper assembled data on the number of lynchings each year in the South and on the price of an acre's yield of cotton. He calculated the correlation coefficient between the two series at -0.532. In other words, when the economy was doing well, the number of lynchings was lower.... In 2001, Donald Green, Laurence McFalls, and Jennifer Smith published a paper that demolished the alleged connection between economic conditions and lynchings in Raper's data. Raper had the misfortune of stopping his analysis in 1929. After the Great Depression hit, the price of cotton plummeted and economic conditions deteriorated, yet lynchings continued to fall. The correlation disappeared altogether when more years of data were added."

So we must be sure to base our conclusions on ALL the data. But in medical research, data selectivity and the "overlooking" of discordant research findings is epidemic.

The Truth About Ancel Keys. Keys was a brilliant man but his concentration on heart disease misled him. He was right that high fat intake predicted high rates of heart disease (though it was ANIMAL fat in particular that was the "culprit") but he overlooked that the same intake predicted LESS mortality from other causes. The same narrow vision led him to be the earliest prominent advocate of the "Mediterranean diet" hypothesis. It's true that Mediterraneans have less heart disease but they have more of other causes of death, so that Mediterranean countries do not have particularly long lifespans when compared with other developed countries. If there are any lessons about diet to be learned from lifespans, it is un-Mediterranean countries like Australia and the Nordic countries that one should look to.

The intellectual Roman Emperor Marcus Aurelius (AD 121-180) could have been speaking of the prevailing health "wisdom" of today when he said: "The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane."

Improbable events do happen at random -- as mathematician John Brignell notes rather tartly: "Consider, instead, my experiences in the village pub swindle. It is based on the weekly bonus ball in the National Lottery. It so happens that my birth date is 13, so that is the number I always choose. With a few occasional absences abroad I have paid my pound every week for a year and a half, but have never won. Some of my neighbours win frequently; one in three consecutive weeks. Furthermore, I always put in a pound for my wife for her birth date, which is 11. She has never won either. The probability of neither of these numbers coming up in that period is less than 5%, which for an epidemiologist is significant enough to publish a paper.

Kids are not shy anymore. They are "autistic". Autism is a real problem but the rise in its incidence seems likely to be the product of overdiagnosis -- the now common tendency to medicalize almost all problems.

One of the great pleasures in life is the first mouthful of cold beer on a hot day -- and the food Puritans can stick that wherever they like

NOTE: The archives provided by blogspot below are rather inconvenient. They break each month up into small bits. If you want to scan whole months at a time, the backup archives will suit better. See here or here